The 2019 ESSKA traumatic meniscus consensus pooled 45 European knee specialists to answer 27 clinical questions on managing acute meniscus tears. It covers definition, epidemiology, diagnosis, and treatment — asking what the current evidence actually supports. The core question: when should surgeons repair rather than resect, and what factors should drive that decision?
The 30-to-10 gap is the number to know: more than 30% of traumatic tears are repairable, but fewer than 10% actually get repaired. The gap exists because meniscectomy is faster, cheaper, and has a lower short-term revision rate — all factors that benefit the surgeon more than the patient.
When you see a traumatic tear, default toward repair rather than resection. The consensus explicitly removes the most common excuses for meniscectomy: BMI up to 35 is not a contraindication, older age is not a contraindication, long tears are not a contraindication, and zone 3 location is not a contraindication.
For lateral tears found at ACL reconstruction, small stable tears can be left in situ. They do well. Medial tears warrant repair. And if you are staging the ACL reconstruction separately, do not wait: meniscus re-tear risk climbs 1% per month in the ACL-deficient knee.
Do not add PRP, rasping, or any biologic adjunct expecting it to improve healing. None have been confirmed to work in humans as of this consensus.
Management of Traumatic Meniscus Tears: the 2019 Esska Meniscus Consensus
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The 2019 ESSKA traumatic meniscus consensus pooled 45 European knee specialists to answer 27 clinical questions on managing acute meniscus tears. It covers definition, epidemiology, diagnosis, and treatment — asking what the current evidence actually supports. The core question: when should surgeons repair rather than resect, and what factors should drive that decision?
The 30-to-10 gap is the number to know: more than 30% of traumatic tears are repairable, but fewer than 10% actually get repaired. The gap exists because meniscectomy is faster, cheaper, and has a lower short-term revision rate — all factors that benefit the surgeon more than the patient.
When you see a traumatic tear, default toward repair rather than resection. The consensus explicitly removes the most common excuses for meniscectomy: BMI up to 35 is not a contraindication, older age is not a contraindication, long tears are not a contraindication, and zone 3 location is not a contraindication.
For lateral tears found at ACL reconstruction, small stable tears can be left in situ. They do well. Medial tears warrant repair. And if you are staging the ACL reconstruction separately, do not wait: meniscus re-tear risk climbs 1% per month in the ACL-deficient knee.
Do not add PRP, rasping, or any biologic adjunct expecting it to improve healing. None have been confirmed to work in humans as of this consensus.